<%-- 
    Document   : registerBack
    Created on : Nov 19, 2011, 9:21:09 PM
    Author     : Breath
--%>

<%@page contentType="text/html" pageEncoding="UTF-8"%>
<!DOCTYPE html>
<html>
    <body>
        <form action="" method=post>
            <center>
                <table cellpadding=4 cellspacing=2 border=0>
                    <th bgcolor="#CCCCFF" colspan=2>
                        <font size=5>USER REGISTRATION</font>
                        <br/>
                        <font size=1><sup>*</sup> Required Fields</font>
                    </th>
                    <tr bgcolor="#c8d8f8">
                        <td valign=top> 
                            <b>First Name<sup>*</sup></b> 
                            <br/>
                            <input type="text" name="name" value="" size=15 maxlength=20>
                        </td>
                        <td  valign=top>
                            <b>Last Name<sup>*</sup></b>
                            <br/>
                            <input type="text" name="surame" value="" size=15 maxlength=20>
                        </td>
                    </tr>
                    <tr bgcolor="#c8d8f8">
                        <td valign=top>
                            <b>E-Mail<sup>*</sup></b> 
                            <br/>
                            <input type="text" name="email" value="" size=25  maxlength=125>
                            <br/></td>
                        <td  valign=top>
                            <b>Zip Code<sup>*</sup></b> 
                            <br/>
                            <input type="text" name="zip" value="" size=5  maxlength=5>
                        </td>
                        <td  valign=top>
                            <b>Street Name<sup>*</sup></b> 
                            <br/>
                            <input type="text" name="streetName" value="" size=5  maxlength=45>
                        </td>

                    </tr>
                    <tr bgcolor="#c8d8f8">
                        <td valign=top colspan=2>
                            <b>User Name<sup>*</sup></b>
                            <br/>
                            <input type="text" name="username" size=10 value=""  maxlength=10>
                        </td>
                    </tr>
                    <tr bgcolor="#c8d8f8">
                        <td valign=top>
                            <b>Password<sup>*</sup></b> 
                            <br/>
                            <input type="password" name="password" size=10 value=""  
                                   maxlength=10></td>
                        <td  valign=top>
                            <b>Confirm Password<sup>*</sup></b>
                            <br/>
                            <input type="password" name="password2" size=10 value=""  
                                   maxlength=10>
                        </td>
                    </tr>
                    <tr bgcolor="#c8d8f8">
                        <td  valign=top colspan=2>
                            <b>What user type are you?</b>
                            <br>   
                            <input type="radio" name="userType" value="Student">Student 
                            <input type="radio" name="userT" value="Lecturer">Lecturer<br>
                            <input type="radio" name="userT" value="Other Academic Staff">Other Academic Staff
                        </td>
                    </tr>
                    <tr bgcolor="#c8d8f8">
                        <td valign=top colspan="2">
                            <b>Website<sup>*</sup></b> 
                            <br/>
                            <input type="text" name="website" size=15 value=""  
                                   maxlength=10>
                        </td>
                    </tr>
                    <tr bgcolor="#c8d8f8">
                        <td  align=center colspan=2>
                            <input type="submit" value="Submit"> <input type="reset"  
                                                                        value="Reset">
                        </td>
                    </tr>
                </table>
            </center>
        </form>
    </body>
</html>
